First and Last Name
Customer Number
Your Email Address
Your Phone Model
The ICCID of Your SIM Card
Your ordered H2O Plan	H2O Minute Plan (Pay-Go) H2O Wireless - Tarif L - 30 Days H2O Wireless - Tarif L - 60 Days H2O Wireless - Tarif M - 30 Days H2O Wireless - Tarif M - 60 Days H2O Wireless - Tarif M - 90 Days H2O Wireless - Tarif S - 30 Days H2O Wireless - Tarif S - 60 Days H2O Wireless - Tarif S - 90 Days H2O Wireless - Tarif XL - 30 Days H2O Wireless - Tarif XL - 60 Days
Destination Airport in the USA	Alabama, Huntsville Alaska, Anchorage Arizona, Phoenix Arizona, Tucson California, Del Mar California, Los Angeles California, Los Gatos California, Pacific Grove California, Placer California, Sacramento California, San Diego California, San Francisco Colorado, Denver Florida, Clearwater Florida, Ft. Lauderdale Florida, Ft. Myers Florida, Haines City Florida, Miami Florida, Naples Florida, Orlando Florida, Tallahassee Florida, Tampa Florida, Titusville Florida, West Palm Beach Georgia, Atlanta Hawaii, Honolulu Haymarket, Virginia Illinois, Chicago Indiana, Indianapolis Kansas, Wichita Louisiana, New Orleans Maryland, Baltimore Massachusetts, Boston Michigan, Detroit Michigan, Macomb County Minesota, Glencoe Minnesota, Minneapolis Missouri, Kansas City Missouri, Rock Port Missouri, Springfield Nevada, Las Vegas New Jersey, Newark New York, Hallsdale New York, New York City New York, Syracuse New York, White Falls North Carolina, Chapel Hill North Carolina, Charlotte, NC North Carolina, Fayettville North Carolina, Raleigh North Carolina, Wilson Ohiio, Cincinnati Ohio, Columbus Oregon, Portland Pennsylvania, Philadelphia Pennsylvania, Pittsburg Tennessee, Nashville Texas, Abilene Texas, Austin Texas, Dallas Texas, Houston Utah, Salt Lake City Virginia, Richmond Virigina, Castlewood Washington D.C, Washington Washington, Seattle Wisconsin, De Pere
Date on which we activate the balance
Your return date
I acknowledge that my smartphone must support the frequencies required by H2O Wireless and must have VoLTE enabled for calls. Without these, I will have no reception and/or cannot make calls.	Yes, I understand. Please activate my SIM card.
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